Female Gender Is Associated with Higher Susceptibility of Weight Induced Arterial Stiffening and Rise in Blood Pressure.

Junli Zuo,Alberto P Avolio,Biwen Tang,Janis Marc Nolde,Audrey Adji,Markus P Schlaich,Huijuan Chao,Revathy Carnagarin

doi:10.3390/jcm10163479

Abstract

Arterial stiffness is an important predictor of cardiovascular events, independent of traditional risk factors. Stiffening of arteries, though an adaptive process to hemodynamic load, results in substantial increase in the pulsatile hemodynamic forces that detrimentally affects the microcirculation perfusing the vital organs such as the brain, heart and kidneys. Studies have proposed that arterial stiffness precedes and may contribute to the development of hypertension in individuals with obesity. Our study sought to determine the gender-based effects on arterial stiffening in obesity which may predispose to the development of hypertension. We found female sex is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure in obesity. Women had significantly higher carotid-femoral pulse wave velocity (CF-PWV) with higher body mass index (BMI) status (normal: 7.9 ± 2 m/s; overweight: 9.1 ± 2 m/s; obese: 9 ± 2 m/s, p < 0.001), whereas it was similar in males across all BMI categories. The linear association between arterial stiffness and BMI following adjustment for age and brachial systolic and diastolic blood pressure (BP), remained significant in females (β = 0.06; 95% CI 0.01 to 0.1; p < 0.05) but not in males (β = 0.04; 95% CI −0.01 to 0.1; p > 0.05). The mean CF-PWV values increased by 0.1 m/s for every 1 kg/m2 increase in BMI in the female subjects in the age adjusted linear model, while such effect was not seen in the male subjects. In line with arterial stiffening, the overweight and obese females demonstrated significantly higher systolic brachial BP. (BP difference: ΔBP 9−11 mmHg, p < 0.01) and central systolic pressure (ΔBP 8−10 mmHg, p < 0.05) compared to their lean counterparts, unlike the male subjects. Our results suggest that female gender is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure.

Highlights

IntroductionObesity is a pandemic on the fast track, associated with adverse cardiovascular (CV)
Obesity is a pandemic on the fast track, associated with adverse cardiovascular (CV)outcomes in both genders
These results demonstrate that excess body weight in females is associated with increased risk of vascular target organ damage (TOD), with the female gender being more susceptible to the development of hypertension in obesity, compared to the male counterparts

Summary

Introduction

Obesity is a pandemic on the fast track, associated with adverse cardiovascular (CV). Hypertension is an increasingly prevalent risk factor that often coexists with obesity in both men and women, mostly attributable to the increasing obesity prevalence [1,2]. Recent trends reveal that ~70% of arterial hypertension is associated with obesity [1]. Elevation in arterial stiffening is a marker of vascular target organ damage (TOD) and has emerged as an independent predictor of future cardiovascular events [3,4]. Stiffening of the arterial wall and earlier return of the reflected pressure pulse wave are key determinants for elevation in systolic blood pressure (BP) at the central level, resulting in the detrimental CV outcomes independent of peripheral BP [3]. Arterial stiffness has been identified to precede and contribute to the development of hypertension in the general population [5], and arterial stiffness mediated hemodynamic changes have been implicated in the development and progression of hypertension [6,7]

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